The Hopkins ACTU proposal is designed to take maximum advantage of the Hopkins AIDS Care Program, scientific resources of this institution, priorities of the Program Office and statewide needs for its underserved population. Major changes in ACTU activities during the past two years reflect emphasis areas of the Division of AMS including studies of opportunistic infections and inclusion of underrepresented populations. Accomplishments during the prior grant period include: enrollment of 596 patients which ranks eighth among all ACTUs; enrollment of 225 participants during the last year which ranks second; enrollment of 175 blacks, which ranks first; development of an 01 study team in 1989 with subsequent enrollment of 175 patients in 12 OI protocols; protocol chair for 14 ACTG protocols; development of a unique minority outreach program and networking of ACTU resources that easily reach 80-90% of persons with known HIV infection in the metropolitan Baltimore area (with the potential of adding Washington DC to our catchment area). The major referral network for our ACTU now includes the Hopkins AIDS Care Program under our direct supervision (2500 patients), two STD Clinics (1750 identified patients with HIV infection) and the Maryland Division of Corrections (estimated 1600 patients with HIV infection). Demographics of these 5250 patients show 81% are black, 25% are women, and 56% have IV drug use as their risk factor. Our referral network also includes community physicians who have previously provided 37% of ACTU participants. Emphasis areas of the Hopkins ACTU include: 1) the Neurology Department supervised by Dr. R. Johnson with Dr. McArthur as our continued link; 2) Oncology with Dr. R. Ambinder, Director of the Hopkins Lymphoma Service; 3) Dr. M.L. Clements, Director of the Hopkins AIDS Vaccine Evaluation Unit; 4) Dr. H. Francis, a minority physician who leads our minority outreach initiative; 5) Dr. P. Lietman, Director of Clinical Pharmacology, who supervises our phase I trials. The ACTU has been a critical resource for Hopkins and for Maryland in scientific contributions, for improving access to research for underserved populations and for optimal management of HIV infection through statewide linkages.